Girl Scout Community Delegate Election Form

For the Girl Scout Year 2016-2017

"Election of delegates shall be held in the first Service Unit* meeting following the annual meeting."

(GSHPA Bylaws, Article 1/Section 5)

(*Now known as 'Girl Scout Community.')

Girl Scout Community Delegate Formula/Allocation

1 Delegate for up to 200 registered girl members*

2 Delegates for 201-400 registered girl members*

3 Delegates for 401-600 registered girl members*

4 Delegates for 601 or more registered girl members*

*Registered girl membership as of September 30 of previous membership year.

Girl Scout Community Number *

Girl Scout Community Name, if known

Submitted by *

Date of Election * +

Date Submitted * +

Girl Scout Community Delegates

	Name	Street Address (Include city, state, zip)	Email Address*
1.	Name	Street Address (Include city, state, zip)	Email Address*
2.	Name	Street Address (Include city, state, zip)	Email Address*
3.	Name	Street Address (Include city, state, zip)	Email Address*
4.	Name	Street Address (Include city, state, zip)	Email Address*

Girl Scout Community Delegate Alternates

	Name	Street Address (Include city, state, zip)	Email Address*
1.	Name	Street Address (Include city, state, zip)	Email Address*
2.	Name	Street Address (Include city, state, zip)	Email Address*
3.	Name	Street Address (Include city, state, zip)	Email Address*
4.	Name	Street Address (Include city, state, zip)	Email Address*

*All communications from Council will be sent via email unless another method is requested.

I certify that my Girl Scout Community held an open election according to the Bylaws of GSHPA and these are the results. *

Yes

Name of Girl Scout Community Lead *

Today's Date * +

Girl Scouts in the Heart of PA

Delegate Elections

350 Hale Avenue

Harrisburg, PA 17104

Phone: 1.800.692.7816

Fax: 717.901.5987